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CLO > Lacrimal Gland & Tear Film Pathologies > Flashcards

Lacrimal Gland & Tear Film Pathologies Flashcards

1
Q

Dacryocystis: Aetiology

A

Inflammation of lacrimla sac

Can be acute or chronic

Cause by infections, blockages or poor patency of nasolacrimal duct (injury/infection/congenital abnormality)

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2
Q

Dacryocystis: Predisposing Factors

A

Congenital nasolacrimal duct blockage

Female

Trauma or surgery

Sinusitis

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3
Q

Dacryocystis: Signs

A

Swelling around lacrimal duct (inferior nasal)

Red

Discharge from puncta mucopurulent

Can present with preseptal cellulitis and conjunctivitis

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4
Q

Dacryocystis: Symptoms

A

Tneder/painful

Epiphora

Fever

Acute onset

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5
Q

Dacryocystis: Differential Diagnosis

A

Cellulitis - if limits eye movement or redness not limited to lacrimal sac area

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6
Q

Dacryocystis: Management by CLO

A

Cease CL wear

Refer

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7
Q

Dacryocystis: Referral

A

Emergency

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8
Q

Dacryoadenitis: Aetiology

A

Inflammation of lacrimal gland

Can be caused by viral or bacterial infection or systemic inflammatory conditions

Usually self limiting

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9
Q

Dacryoadenitis: Predisposing Factors

A

Uncommon

Male/female equal

No common age

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10
Q

Dacryoadenitis: Signs

A

Swelling around lacrimal gland (superior temporal)

Red

Watery and puss discharge

Ptosis of lid due to swelling

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11
Q

Dacryoadenitis: Symptoms

A

Tender/painful

Excessive tearing with discharge

Acute or chronic depending on cause

Fever

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12
Q

Dacryoadenitis: Differential Diagnosis

A

Cellulitis

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13
Q

Dacryoadenitis: Management by CLO

A

Cease CL wear

Monitored for self resolution (adults)

Chronic should be referred for investigation of cause

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14
Q

Dacryoadenitis: Referral

A

Emergency for children

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15
Q

Ectropian: Aetiology

A

Lower lid turns out with loss of tone

Especially at nasal corner with poor location of puncta for drainage

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16
Q

Ectropian: Predisposing Factors

A

Age - 60+

Trauma

Tumours

Surgery

Palsy

Congenital

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17
Q

Ectropian: Signs

A

Red adnexa from epiphora

Dry eye symtoms

Watery eyes

Exposure keratitis inferior

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18
Q

Ectropian: Symptoms

A

Continual epiphora - continuously wiping tears

Soreness of cheek from epiphora

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19
Q

Ectropian: Management by CLO

A

Advise to wipe upwards

Bandage CL where corneal exposure risks keratitis

20
Q

Ectropian: Referral

A

Routine for surgery with keratitis and chronic epiphora

21
Q

Ectropian: Contact Lens implications

A

Dry eye due to poor tear movement

High risk for conjunctivitis

High risk of keratitis

Daily lenses with low water content or SiHy bandage lens

22
Q

Lid Notching (MGD): Aetiology

A

Lower lid notching due to atrophy of meibomian glands

Irreversible

Gland puckered inwards

23
Q

Lid Notching (MGD): Predisposing Factors

A

Chronic posterior blepharitis

24
Q

Lid Notching (MGD): Signs

A

Irregular lid margin

Notched areas with poor contact on globe

Epiphora

Dry eye along side MGD

Poor tear flow

25
Q

Lid Notching (MGD): Symptoms

A

Epiphora

Dry eye symptoms

26
Q

Lid Notching (MGD): Management by CLO

A

Treatment of MGD/blepharitis

Use of lubricants

Hot compresses

27
Q

Lid Notching (MGD): Referral

A

None

28
Q

Lid Notching (MGD): Contact Lens Implications

A

Cry eye due to poor tear movement/drainage

Limitations on wear time (poor tears/evaporation)

29
Q

Evaporative Dry Eye: Aetiology

A

Multifactorial disease

Likely cause by poor patency or pathology of meibomian glands

Hyperosmolarity caused which destabilises tears and causes inflammation

30
Q

Evaporative Dry Eye: Predisposing Factors

A

Environmental factors

VDU use

Refractive surgery

CL wear

Age

Menopause

31
Q

Evaporative Dry Eye: Signs

A

Congealed meibomian gland orifices

Creamy discharge

Hardened lumps on gland orifices

Lid notching

32
Q

Evaporative Dry Eye: Symptoms

A

Dry eye symptoms

Lens intolerance

Watery eyes in windy conditions

33
Q

Evaporative Dry Eye: Grading

A

Use Efron to grade MGD

Measuring osmolarity is best for monitoring

Can grade bulbar conjunctival redness & staining caused by dry eye

34
Q

Evaporative Dry Eye: Differential Diagnosis

A

Conjunctivitis

Incomplete blink reflex/incomplete lid closure at night

Associated blepharitis

Aqueous deficient dry eye

35
Q

Evaporative Dry Eye: Management by CLO

A

Treatment for chronic MGD/blepharitis

Advise lubricants

Hot compresses

Education on environment/VDU breaks

Increase omega 3 and water intake

36
Q

Evaporative Dry Eye: Referral

A

Routine - can receive antibiotics for chronic MGD

37
Q

Evaporative Dry Eye: Contact lens implications

A

CL intolerence

Limit on wear due to poor tears and increased evaporation

Increased risk of infection

38
Q

Aqueous Deficient Dry Eye: Aetiology

A

Multifactorial disease based on reduced tear quantity

39
Q

Aqueous Deficient Dry Eye: Predisposing Factors

A

Systemic inflammatory challenges

Innervation of lacrimal gland problems

Sjogren’s disease sufferer

Dehydration

40
Q

Aqueous Deficient Dry Eye: Signs

A

Reduced tear meniscus

Minimal tear coverage

Poor take up of fluorescein

Mucal strands on cornea

Blurred vision

41
Q

Aqueous Deficient Dry Eye: Symptoms

A

Severe dry eye symptoms

Blurred vision

42
Q

Aqueous Deficient Dry Eye: Differential Diagnosis

A

Conjunctivitis

Incomplete blink reflex

Associated blepharitis

Evaporative dry eye

43
Q

Aqueous Deficient Dry Eye: Management in practice

A

Artificial tears

Bandage contact lens

44
Q

Aqueous Deficient Dry Eye: Referral

A

Routine

  • treatment of underlying systemic concerns
  • permanent occulsion of puncta
  • autologous serum drops
45
Q

Aqueous Deficient Dry Eye: Contact Lens Implications

A

Likely unsuitable for contact lenses until treated

Low water content lenses

Bandage lenses

CLO (13 decks)

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